Active NPI
David Rosenbeck
- Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1760037394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71009501A
- Practice address
- 11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739 - Phone
- (833) 724-8326
- Fax
- (260) 425-6789
- NPI assigned
- Aug 9, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 01076682A | IN | |
| Nurse Practitioner | 363L00000X | 71009501A | IN | Primary |
Addresses
Primary practice location
11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739
Mailing address
3702 New Vision Dr BLDG B
Fort Wayne, IN 46845-1703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71009501A | IN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1760037394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 NEW VISION DR BLDG B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11050 PARKVIEW CIRCLE DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451739",
"telephone_number": "833-724-8326",
"fax_number": "260-425-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBECK",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-09",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "01076682A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71009501A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.